The present invention relates to medical image-based simulation of atrial electrophysiology, and more particularly to medical image-based simulation of atrial electrophysiology using a personalized computational model of atrial electrophysiology.
Cardiac arrhythmia is any of a group of conditions in which the rate or rhythm of the heartbeat is irregular. Cardiac arrhythmia is typically associated with abnormal initiation and/or abnormal propagation of a wave of cardiac excitation. The most common atrial arrhythmias are atrial flutter and atrial fibrillation. Atrial flutter (AFL) is a reentrant supraventricular arrhythmia characterized by a rapid “sawtooth” appearance of the electrocardiogram (ECG) owing to the presence of multiple P waves between the QRS complexes. AFL can be paroxysmal (which lasts for hours or days) or persistent (which is more or less permanent) and often induces electrical remodeling and thereby can serve as a precursor to atrial fibrillation.
Atrial fibrillation (AFib) is the most common cardiac arrhythmia. As one of the major risk factors for worsening heart failure (HF), AFib is associated with significant morbidity and mortality. AFib is characterized by rapid, seemingly chaotic atrial activation, and is clinically confirmed with the absence of P waves and irregular ventricular rate (QRSs) in the ECG. AFib can be paroxysmal or persistent. Multiple pathophysiological processes have been identified as contributors to the initiation and maintenance of AFib; however, many aspects remain incompletely understood.
Treatment options for atrial arrhythmia include direct electrical cardioversion, pharmacologic therapy, and catheter ablation of the underlying reentrant circuit. No current antiarrhythmic drug (AAD) is atrial specific and therefore care must be taken to avoid adverse effects on the ventricular rhythm. The seemingly superior ablation approach still has unknown effects in terms of mortality, and the most effective but less invasive ablation line pattern is still under study. Tools that provide better patient stratification and therapy planning for atrial arrhythmias are desirable.